开放胸腹大动脉修复的当代结果:一个单中心的经验
N A Hasami1, M Smulders1, M W A Verkroost1
1Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Interdisciplinary cardiovascular and thoracic surgery
|February 5, 2025
概括
胸腹大动脉动脉瘤的开放修复是有效的,显示低死亡率和并发症率. 这种方法仍然是复杂病例的重要选择,特别是当内血管修复不适合时.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 大动脉疾病管理管理
背景情况:
- 胸腹大动脉动脉瘤 (TAAAs) 存在重大外科手术挑战,死亡率高.
- 内血管修复不适用于所有患者,特别是年轻患者或有结缔组织疾病的患者.
研究的目的:
- 评估胸腔腹腔大动脉瘤 (TAAA) 开放外科修复的当代结果.
- 评估手术死亡率,脊髓损伤,中风,气管切除术和透析率.
- 为了比较选修和非选修开放TAAA修复之间的结果.
主要方法:
- 对190名接受TAAA开放修复 (2015-2023) 的患者 (克劳福德-萨菲类型I-V) 的前性记录数据的回顾性分析.
- 包括选修和非选修的情况.
- 主要终点:手术死亡率;次要终点:神经并发症,呼吸支持,功能.
主要成果:
- 术后死亡率为7.9% (7.5%为选择性,9.1%为非选择性).
- 报告了脊髓损伤 (7.4%),中风 (5.8%),气管切除术 (3.7%) 和透析 (6.9%) 的发生率.
- 观察到严重的急性损伤率 (38.4%).
结论:
- 开放的TAAA修复,具有多学科团队和严格的协议,是有效的.
- 这种方法表明复杂的TAAA管理可接受的死亡率和并发症率.
- 开放式手术仍然是不适合内血管修复的患者的关键选择.
相关概念视频
Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...


